Prostate specific antigen (PSA)–only relapse following local therapy for high-risk prostate cancer
Discussant: Kurt Miller, MD
A 65-year-old man is diagnosed with prostate cancer after screening PSA is found to be elevated.
- PSA: 22 ng/mL (confirmed)
- Clinical stage: T1c
- Pathology: 3/6 (L) core biopsies positive. Gleason score 7 (4 + 3). 2/6 (R) core biopsies positive. Gleason score 8 (4 + 4)
- Staging: Bone scan—negative MRI with endorectal coil—organ confined disease, no pelvic nodes CXR—normal
- Medical history: Hypertension, well controlled
PART 1PART 2Radical prostatectomy was performed.
• Pathology: pT2 with positive margin. Gleason 7 (4 + 3)
• Nadir postoperative PSA undetectable
• 2.5 years postoperative routine PSA was 0.1 ng/mL (confirmed)
• 3 months later PSA was 0.2 ng/mL
• 3 months later PSA was 0.3 ng/mL
• Metastatic evaluation—negative
• Pathology: pT2 with positive margin. Gleason 7 (4 + 3)
• Nadir postoperative PSA undetectable
• 2.5 years postoperative routine PSA was 0.1 ng/mL (confirmed)
• 3 months later PSA was 0.2 ng/mL
• 3 months later PSA was 0.3 ng/mL
• Metastatic evaluation—negative
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